Year 2024 / Volume 116 / Number 6
Digestive Diseases Image
“Grey areas” in large rectal neuroendocrine tumors: when endoscopic ultrasound becomes the silver lining

334-335

DOI: 10.17235/reed.2023.9893/2023

Vi­tor Macedo Silva, Joana Magalhães, Sílvia Leite, José Cotter,

Abstract
A 50-years old male with irrelevant medical history underwent colonoscopy for colorectal cancer screening. On the distal rectum, a subpedunculated (Paris classification Isp) lesion with 15mm was detected. This lesion presented yellowish mucosa and had irregular surfaces, suggesting a subepithelial lesion. Bite-on-bite biopsy confirmed a well-differentiated neuroendocrine tumor (r-NET), positive for synaptophysin, with a low-proliferative index. As r-NETs with 10-20mm fall on a grey area between endoscopic or surgical treatment, a lower endoscopic ultrasound (EUS) was performed, showing a round hypoechoic “salt and pepper” lesion of the mucosa, with focal involvement of the submucosa (3rd layer), but without muscularis propria invasion or regional lymph node involvement (uT1N0). No distal metastases were detected on computed tomography. Thus, the patient was proposed for endoscopic submucosal dissection. With this case we aim to recall EUS importance in large r-NETs, as adequate staging is crucial when deciding optimal therapeutic options.
Share Button
New comment
Comments
No comments for this article
References
Pavel M, Öberg K, Falconi M, et al. Gastroenteropancreatic neuroendocrine neoplasms: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020;31(7):844-860.
Related articles

Letter

Duodenal lymphangiomas: endoscopic ultrasound features

DOI: 10.17235/reed.2024.10338/2024

Letter

A submucosal lesion of the rectum: an unexpected MALT

DOI: 10.17235/reed.2023.9846/2023

Digestive Diseases Image

Imaging of pancreatic desmoid fibromatosis by endoscopic ultrasound

DOI: 10.17235/reed.2023.9792/2023

Letter

Surgical indication of type I gastric neuroendocrine tumors

DOI: 10.17235/reed.2023.9681/2023

Letter

Carcinoid syndrome and somatostatin analogues

DOI: 10.17235/reed.2023.9525/2023

Digestive Diseases Image

Endosonographic and ERCP findings in COVID-19 critical illness cholangiopathy

DOI: 10.17235/reed.2022.9218/2022

Letter

Angiosarcoma of the aorta diagnosed via endoscopic ultrasound

DOI: 10.17235/reed.2022.8879/2022

Letter

Ectopic ACTH syndrome in a patient with Crohn’s disease

DOI: 10.17235/reed.2022.8825/2022

Digestive Diseases Image

Pancreatic lymphoma during pregnancy

DOI: 10.17235/reed.2022.8811/2022

Digestive Diseases Image

When needles are not enough, forceps delivers!

DOI: 10.17235/reed.2022.8697/2022

Digestive Diseases Image

Endoscopic resection of a duodenal neuroendocrine tumor

DOI: 10.17235/reed.2021.8232/2021

Letter

Lumen-apposing metal stent deployment failure

DOI: 10.17235/reed.2020.7060/2020

Digestive Diseases Image

A rare cause of extrahepatic biliary tract stricture: a neuroendocrine carcinoma

DOI: 10.17235/reed.2020.6491/2019

Letter

Klatskin-mimicking neuroendocrine tumor

DOI: 10.17235/reed.2019.6382/2019

Letter

Sometimes things are what they seem

DOI: 10.17235/reed.2019.5911/2018

Letter

A giant abdominal collection: when things are not what they seem

DOI: 10.17235/reed.2018.5642/2018

Letter to the Editor

Author´s reply: Cystic pancreatic neuroendocrine tumors. A diagnostic challenge

DOI: 10.17235/reed.2018.5415/2017

Letter to the Editor

Late migration of a metal stent after EUS-drainage of a pancreatic pseudocyst abscess

DOI: 10.17235/reed.2018.5411/2017

Letter to the Editor

EUS-guided ethanol ablation therapy for gastric stromal tumors

DOI: 10.17235/reed.2017.5361/2017

Letter to the Editor

A case of a mixed adenoneuroendocrine tumor of the colon

DOI: 10.17235/reed.2017.5008/2017

Letter to the Editor

Neuroendocrine tumors of the pancreas: keys issues in dealing with heterogeneity

DOI: 10.17235/reed.2017.4997/2017

Letter to the Editor

Pancreatic neuroendocrine tumors. Prognostic factors

DOI: 10.17235/reed.2017.5109/2017

Letter to the Editor

A rectal neuroendocrine neoplasm

DOI: 10.17235/reed.2017.4836/2017

Letter to the Editor

Utility of neoadjuvant therapy in rectal GIST

DOI: 10.17235/reed.2017.4751/2016

Letter to the Editor

Pancreatic neuroendocrine tumors

DOI: 10.17235/reed.2017.4725/2016

Editorial

Pancreas neuroendocrine tumors - not so rare or benign

DOI: 10.17235/reed.2016.4672/2016

Digestive Diseases Image

Intrauterine device in the rectal cavity

Letter to the Editor

Unusual presentation of obstructive jaundice

DOI: 10.17235/reed.2017.4501/2016

Letter to the Editor

Gastric neuroendocrine tumor presenting with gastrointestinal bleeding

DOI: 10.17235/reed.2015.3998/2015

Case Report

Primary squamous cell carcinoma of the rectum: an atypical histology

DOI: 10.17235/reed.2016.3975/2015

Review

Endoscopic ampullectomy: a technical review

DOI: 10.17235/reed.2016.3867/2015

Case Report

Pelvic inflammatory myofibroblastic tumor mimicking a rectal cancer

DOI: 10.17235/reed.2015.3777/2015

Case Report

Malignant degeneration of rectal endometriosis

DOI: 10.17235/reed.2015.3648/2014

Citation tools
Macedo Silva V, Magalhães J, Leite S, Cotter J. “Grey areas” in large rectal neuroendocrine tumors: when endoscopic ultrasound becomes the silver lining. 9893/2023


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 648 visits.
This article has been downloaded 61 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 05/08/2023

Accepted: 31/08/2023

Online First: 21/09/2023

Published: 04/06/2024

Article Online First time: 47 days

Article editing time: 304 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology